| NPI | 1033267794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N4526) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C52449) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2012-08-28 |